| Stent-Graft Limb Deployment in the External Iliac Artery Increases the Risk of Limb Occlusion Following Endovascular AAA Repair. | |
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MedLine Citation:
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PMID: 22313206 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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Abstract Purpose: To assess whether deployment of an endograft limb in the external iliac artery (EIA) increases the rate of limb occlusion following endovascular aneurysm repair (EVAR). Methods: Interrogation of a prospectively maintained database identified 661 patients (596 men; median age 73 years, range 37-93) with infrarenal abdominal aortic aneurysm who underwent EVAR between 1996 and 2010 using Zenith stent-grafts predominately. Of these, 567 patients [56 (9.9%) women] had both endograft limbs deployed in the CIA (1203 limbs at risk), while 94 patients [9 (9.6%) women] had at least 1 limb in the EIA (22 bilateral; 116 limbs at risk). An adjunctive bare metal stent was used in 8 (9%) limbs deployed in the EIA. Results: There were 31 limb occlusions, all unilateral: 17 (3%) patients in the CIA group had an occluded limb (1% of limbs at risk) vs. 14 (15%) patients in the EIA group (12% of limbs at risk; p<0.0001). The median time to occlusion was 3 months (0-60) in the CIA group and 1 month (0-36) in the EIA group. The majority of occlusions were treated by extra-anatomical revascularization, most often a femorofemoral crossover bypass. No legs were amputated following occlusion of a limb placed in the CIA, but there were 3 amputations in the EIA group (p = 0.003). Conclusion: Deployment of endograft limbs into the EIA led to a higher rate of occlusion and leg amputation. Increased tortuosity of the EIA and a smaller caliber vessel are likely to account for the increased risk. |
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Authors:
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Allan M Conway; Bijan Modarai; Peter R Taylor; Tom W G Carrell; Matthew Waltham; Richard Salter; Rachel E Bell |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists Volume: 19 ISSN: 1545-1550 ISO Abbreviation: J. Endovasc. Ther. Publication Date: 2012 Feb |
Date Detail:
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Created Date: 2012-02-08 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100896915 Medline TA: J Endovasc Ther Country: United States |
Other Details:
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Languages: eng Pagination: 79-85 Citation Subset: IM |
Affiliation:
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Department of Vascular Surgery, Guy's and St Thomas' Hospital, London, UK. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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